New Research Study Published by ALPP Director and Colleagues on the Impact of COVID-19 on Lactation Support Professionals

An article by Academy of Lactation Policy and Practice Director, Ellie Mulpeter, and colleagues from Curry College and the Healthy Children Project, Inc., just published in Frontiers of Public Health, is the first to explore the experiences of lactation support professionals during the early months of the COVID-19 pandemic.

Over 600 participants completed a qualitative survey questionnaire recounting their experiences of working during such a chaotic and challenging time. As members of the healthcare team, Certified Lactation Counselors© (CLC©) were on the front lines, supporting families who were giving birth amidst a pandemic.

This study emphasized how fear and a lack of support impacted the ability of CLCs to continue to deliver evidence-based care and maintain access to care for all families – thus highlighting the importance of preparation for future public health crises.

The full article is published in Frontiers of Public Health and is available with open access here.

New, Expanded Childbirth And Breastfeeding TRICARE Benefits For Expecting Parents



Are you an expecting parent? Are you thinking of having a child? TRICARE is now providing more options to those who are planning to expand their family. As of Jan. 1, TRICARE added new childbirth and breastfeeding benefits under the Childbirth and Breastfeeding Support Demonstration (CBSD). CBSD is for those enrolled in TRICARE Prime and TRICARE Select in the U.S. under one of the TRICARE regional contractors.

As part of this five-year study, TRICARE covers the services of three new types of TRICARE-authorized providers:


  • Certified labor doulas
  • Certified lactation consultants
  • Certified lactation counselors


“With the CBSD, we’re evaluating the cost, quality of care, administrative feasibility, and the impact on birthing parents and infants of using trained, non-medical professionals as extra maternal health providers,” said Erica Ferron, management and program analyst with the TRICARE Health Plan. “At the end of the study, TRICARE will review the findings and then decide whether or not to make this coverage permanent.”

Both benefits are only for TRICARE Prime and TRICARE Select enrollees. And you must use civilian providers. This means the CBSD isn’t available at military hospitals and clinics. It’s also not available if you have coverage through:


You don’t need referrals to use network providers. If you have TRICARE Prime, you’ll need a referral from your primary care manager to see a non-network provider. Without a referral, you may have point-of-service charges.

What are these new services? How can you qualify? The answers are below.

Certified Labor Doulas
TRICARE will cover up to six visits by certified labor doulas, either before or after you give birth. You also get one doula visit for the length of your delivery. These doulas are trained professionals who provide non-medical support for birthing parents.

“TRICARE is breaking new ground by covering doula services,” added Ferron. “The support services provided by certified labor doulas will complement maternity services by TRICARE-authorized physicians and other medical professionals.”

TRICARE is creating a network of certified labor doulas. You can use a doula outside of the network. But you must make sure your doula still meets the CBSD qualifications for you to get reimbursement.

To qualify for doula visits, you must:

  • Be at least 20 weeks pregnant
  • See a TRICARE-authorized provider for your birth event

As part of the CBSD, you can’t plan to give birth in a military hospital or clinic. But you can give birth with a certified nurse midwife at home if that midwife is a TRICARE-authorized provider. If you don’t use a midwife who is authorized by TRICARE, the CBSD won’t cover the services.

Lactation Consultants and Lactation Counselors
As outlined in the TRICARE Maternity Care Brochure, TRICARE covers breastfeeding counseling, as well as breast pumps and supplies. With the CBSD, TRICARE is expanding that coverage. There are many lactation consultants and counselors who are highly trained, but not fully licensed medical providers. Expanding coverage to these providers will help you have more access to qualified lactation experts.

The CBSD also adds coverage for group breastfeeding counseling. These sessions count toward the six total allowed outpatient counseling sessions you have per birth event.

To qualify for this extra coverage, you must:

How can you enroll in the CBSD? If you’re eligible, you’re automatically enrolled when you submit a claim covered under the CBSD. You can also check with your TRICARE regional contractor to see if you qualify. If you need help finding a provider, talk to your regional contractor.

The CBSD goes until Dec. 31, 2026 stateside. It will expand to overseas and U.S. territories in January 2025. If you want to learn more about CBSD, check out the Childbirth and Breastfeeding Support Demonstration page.

How The Marketing Of Formula Milk Influences Our Decisions On Infant Feeding

This report summarizes the findings of a multicountry study examining the impact of breast milk marketing on infant feeding decisions and practices, which was commissioned by WHO and UNICEF. The research study – the largest of its kind to date – draws on the experiences of over 8500 women and more than 300 health professionals across eight countries (Bangladesh, China, Mexico, Morocco, Nigeria, South Africa, the United Kingdom and Viet Nam). It exposes the aggressive marketing practices used by the formula milk industry, highlights the impacts on women and families, and outlines opportunities for action. 


The report can be downloaded here: How the marketing of formula milk influences our decisions on infant feeding (

INFACT USA and IBFAN UK Protecting and Promoting Breastfeeding at the 75th World Health Assembly

INFACT IBFAN at World Health AssemblyI have had the pleasure of attending the 75th World Health Assembly in Geneva, Switzerland this week, along with other members of the global Infant Baby Food Action Network (IBFAN) team. I have learned so much from other Member States and delegates from all over the world. While there are many public health issues being addressed before the Assembly, our team is here to protect and promote breastfeeding, to strengthen the WHO Code on the Marketing of Breastmilk Substitutes by keeping policy setting free of commercial influence, and to prohibit the cross-promotion of products that function as breastmilk substitutes. Throughout our time here at the WHA, I have also had the opportunity to write a briefing on the contamination and infant formula product shortage occurring in the U.S., which we are now circulating among international delegates. I look forward to returning home and working hard on the establishment of INFACT USA and Code monitoring in the states.”

– Ellie MacGregor,
Director of the Academy of Lactation Policy and Practice
Program Coordinator of INFACT USA (Infant Feeding Action Coalition USA)

INFACT USA and IBFAN UK standing up for breastfeeding as an crucial strategy for optimizing public health


Report on IBFAN / INFACT Activities at the 27th World Health Assembly

also available at


WATCH WHA RECORDINGS Agenda 18, Committee B  6th and 7th session Friday 27th May HERE and HERE

Fast forward to 00.59 –  Strategic Round Table on WHO Sustainable financing Monday, 23rd May.

Baby Milk Action’s Patti Rundall welcomes the increase in Assessed Contributions then asks WHO about its Conflict of Interest policy that only excludes arms and tobacco rather than all health harming industries. Dr Tedros Adhanom Ghebreyesus responds by saying ‘What she said is true by the way …”

(1)The 8 Country  Marketing reportReport on Digital Marketing  and  The 2022 State of the Code report – Effective regulatory Frameworks for ending inappropriate marketing of BMS and baby foods in the WHO European Region

[2] The 1992 Export Directive (92/52/EEC) and Council Resolution called for Code compliance by EU Based companies when marketing in ‘third countries’ along with monitoring and reporting and accountability proposals.  The Codex CODE OF ETHICS FOR INTERNATIONAL TRADE IN FOOD requires Member States to “…make sure that the international code of marketing of breast milk substitutes and relevant resolutions of the World Health Assembly (WHA) setting forth principles for the protection and promotion of breastfeeding be observed.”

CLICK HERE for IBFAN  interventions made at the 150th Executive Board Meeting. Click here for the IBFAN Blog on the run up to the EB.


Maternal Infant and Young Child Nutrition and Food Safety   Agenda Item 18.1  read by Elisabeth Sterken

Over 800,000 babies die every year because of unsafe feeding, and many more do not reach their full potential because they are not breastfed.  This year four WHO reports show that too many of the 144 countries with Code legislation have serious loopholes allowing predatory marketing to flourish.

It’s time that exporting nations take responsibility for the marketing activities of their companies. WHO, the parent of Codex, must defend Assembly decisions, as amended by Bangladesh,  against challenges by those pushing unnecessary, sweetened, flavoured ultra-processed products.  The forthcoming decisions at Codex will fundamentally affect child health and survival

NCDs and Humanitarian emergencies.  Agenda item 14.1. A75/10 Add 2, Annex 4 read by Patti Rundall

The recommendations on NCD risk factors in humanitarian emergencies rightly calls for strengthened policies and services but also calls for partnerships with the private sector – with  NO mention of the need for conflicts of interest safeguards – nor any mention of the protection of breastfeeding – a resilient practice that protects children from the worst of emergency conditions.

Safeguards must be consistently integrated into ALL policies to ensure that partnerships are appropriate and that policy setting is not commercially influenced.

When talking about health harming industries terms such as ‘partnership’ ’trust’ ‘shared aims’ and ‘values’ is naive.  It blurs identities and responsibilities. Corporations have no democratic accountability and public health policy decisions should be free of their influence.

In times of crisis, companies mislead and exploit public fears, donating inappropriate products that claim to build immunity –  good that WHO supports the statement warning of the risks of formula donations in Ukraine.

Public Health Emergencies.  Agenda Item 16.3  Read by Dr Magdalena Whoolery

As poverty rates, economic disparity, conflicts and hunger are rising, short term treatment models that rely on market-led approaches and fail to recognise how companies undermine health and the environment pose serious risks to child health.  Ready to Use Therapeutic Foods should not be on retail sale and should be used only in programmes that promote skin-to-skin,  re-lactation and continuation of breastfeeding with appropriate transition to nutritious family food and psycho-social support. Micronutrient interventions should be culturally appropriate and not undermine sustainable food production, food security and biodiversity.

As poverty rates, economic disparity, conflicts and hunger are rising, short term treatment models that rely on market-led approaches and fail to recognise how companies undermine health and the environment pose serious risks to child health.  Ready to Use Therapeutic Foods should not be on retail sale and should be used only in programmes that promote skin-to-skin,  re-lactation and continuation of breastfeeding with appropriate transition to nutritious family food and psycho-social support. Micronutrient interventions should be culturally appropriate and not undermine sustainable food production, food security and biodiversity.

We are pleased that WHO  endorsed the joint statement on Ukraine led by UNICEF and UNHC  warning of the risks of donations of baby feeding products.

Informal list of intergovernmental meetings  streamed on the following website: ––non-state-actors-in-official-relations-and-the-secretariat-during-11-april-to-6-may-2022

Non State Actors in Official Relations (such as IBFAN) can listen and intervene on some of these meetings. On the Working Group on Emergency Preparedness (WGPR Intersessional Informal Meeting (Systems and Tools / Finance) on 24th March,  I made the following intervention:

IBFAN – like all  public interest civil society –  supports the call from Germany for a long overdue increase in Member States contributions to WHO. This is important for so many reasons, but essential if WHO is to continue to lead in emergency preparedness and response. Without such secure income and in the absence of strong safeguards on COI there are huge risks. IBFAN is especially concerned about  the need to protect infant and young child feeding and of course breastfeeding – a lifeline in emergencies.  We see now that appeals and funds are being attracted to the WHO Foundation and we’re very, very concerned about this and feel that its policy must be strengthened and donors carefully screened. The Foundation has recently dropped an exclusion criteria from its initial guidance guidelines that would have forced it to reject funding from companies that do not contribute to “a healthy diet.”  And its messages have failed to follow WHO policy and alert the public to the risks of donations of feeding products.

Link from the Home page of WHO 1st March 2022

Link from the Home page of WHO 1st March 2022

Articles about WHO Funding

Report issued by a team around Jonathan Glennie  based on research funded by the BMGF, adapting Glennie’s “global public investment” proposal (The Future of Aid: Global Public Investment) narrative to  the field of financing pandemic preparedness and response

South Centre Research Paper No. 147 (28 February 2022): Can Negotiations at the World Health Organization Lead to a Just Framework for the Prevention, Preparedness and Response to Pandemics as Global Public Goods?


By Viviana Muñoz Tellez  This paper advances that WHO Member States, having agreed to the objectives of advancing equity and solidarity for future pandemic prevention, preparedness and response, now must operationalize these. The paper offers suggestions for the ongoing WHO processes of: 1) review of recommendations under examination by the Working Group on Strengthening WHO Preparedness and Response to Health Emergencies, 2) consideration of potential amendments to the International Health Regulations (IHR) 2005, and 3) elaboration of a draft text for an international instrument on pandemic preparedness and response.

Other articles:

Elaine Ruth Fletcher, Health Policy Watch: “United States Fast Tracks Proposal to Change WHO Rules on International Health Emergency Response”

Human Rights Principles for a Pandemic Treaty
Ongoing publication project and informal working group convened by OSF
A final/full version of the “10 principles” is expected to be published by the end of March
Main messages:

The politics of a WHO pandemic treaty in a disenchanted world
G2H2 research and advocacy project 2021.
Members of the Geneva Global Health Hub are currently exploring a follow-up action


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Betreff: Informal WHA75 pre-meetings during 11 April to 6 May

Dear non-State actors in official relations,

Please find attached the draft concept note for the” Informal WHA75 pre-meetings for Member States, non-State actors in official relations and the Secretariat” to take place over 4 days during the period from 11 April to 6 May 2022. The informal meeting is organized as per the decision of the Executive Board at its 150th meeting. In developing the concept note, the comments and input from non-State actors who attended the planning meeting on 28 February on the concept and content for the meeting , have been considered.

The proposed dates and the agenda for the informal WHA75 premeeting are:

Monday 11 April 2022 at 10:00-13:00 CEST

Pillar 1: One billion more people benefitting from universal health coverage

13.1 Follow-up to the political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases:

(a) Draft implementation road map 2023–2030 for the global action plan for the prevention and control of noncommunicable diseases 2013–2030

(d) Draft recommendations on how to strengthen the design and implementation of policies, including those for resilient health systems and health services and infrastructure, to treat people living with noncommunicable diseases and to prevent and control their risk factors in humanitarian emergencies

(h) Draft action plan (2022–2030) to effectively implement the global strategy to reduce the harmful use of alcohol as a public health priority

21 April 2022 at 15:30-18:30 CEST

Pillar 1: One billion more people benefitting from universal health coverage
Human resources for health

Pillar 3: One billion more people enjoying better health and well-being
17.1 Maternal, infant and young child nutrition

3rd item TBD

28 April 2022 at 15:00-18:00 CEST

Pillar 2: Public health emergencies: preparedness and response
15.2 Strengthening WHO preparedness for and response to health emergencies

15.4 WHO’s work in health emergencies

Pillar 4: More effective and efficient WHO providing better support to countries

Sustainable Financing

Thursday 6.5. at 10.00-11:00 CEST

Engagement modalities

Feedback on the meeting

Constituency statements

The duration of each session is 3 hours, with 3 agenda items for discussion, and with expected participation as panel members from Member States, WHO Secretariat including regional offices and non-State actors in official relations. We would propose that non-State actor representative will moderate the sessions like last time. It is expected that panel members will be respond to questions from the audience and discuss with other panel members on the agenda item. The fourth session on 6 May is dedicated for a discussion on engagement modalities for non-State actors, and to a dialogue between non-State actors and the Director-General as well as giving a space for non-State actors to prepare for the Seventy-fifth World Health Assembly (22 – 28 May 2022). Should you have any suggestions for the format or agenda items of the meeting or comments, especially for the 3rd agenda item on 21 April, please contact

We are calling for expressions of interest from non-State actors to be members of the panels as well as moderators of the panels in this meeting. Kindly indicate your interest to Taina Nakari at by 27 March 2022. Please also let us know which session you are interested in to moderate or to be a panel member. Once all the proposals have been received, we will contact the panel members and moderators to finalize arrangements. Looking forward to working with you to shape the sessions.

Connection details and other practical arrangements will be sent ahead of the meeting.

Thanking in advance for your participation.

Best regards,
Dr Gaudenz Silberschmidt
Health and Multilateral Partnerships
External Relations

Academy Of Breastfeeding Medicine – Considerations For COVID-19 Vaccination In Lactation



Considerations for COVID-19 Vaccination in Lactation


December 14, 2020 – Several countries have recently issued an emergency use authorization (EUA) for the Pfizer/BioNtech mRNA COVID-19 vaccine. A second mRNA COVID vaccine, manufactured by Moderna, will be reviewed in the coming weeks. Since these two vaccines are similar, the information in this document can be applied to both vaccines.


Although there is currently no clinical data on use of COVID-19 mRNA vaccines in lactation, the United States Food and Drug administration EUA left open the possibility of administering the vaccine to both pregnant and lactating individuals.


Many lactating individuals fall into categories prioritized for vaccination, such as front-line health care workers. The Academy of Breastfeeding Medicine does not recommend cessation of breastfeeding for individuals who are vaccinated against COVID-19. Individuals who are lactating should discuss the risks and benefits of vaccination with their health care provider, within the context of their risk of contracting COVID-19 and of developing severe disease. Health care providers should use shared decision making in discussing the benefits of the vaccine for preventing COVID-19 and its complications, the risks to mother and child of cessation of breastfeeding, and the biological plausibility of vaccine risks and benefits to the breastfed child.


These conversations are challenging, because the Pfizer/BioNtech vaccine trial excluded lactating individuals. As a result, there are no clinical data regarding the safety of this vaccine in nursing mothers. However, there is little biological plausibility that the vaccine will cause harm, and antibodies to SARS-CoV-2 in milk may protect the breastfeeding child.


The vaccine is made of lipid nanoparticles that contain mRNA for the SARS-CoV-2 spike protein; the mRNA sequence only encodes this protein. These particles are injected into muscle, where the nanoparticles are taken up by muscle cells. These muscle cells then transcribe the mRNA to produce spike protein. The spike protein made by the cell stimulates an immune response, protecting the individual from COVID-19 illness.


During lactation, it is unlikely that the vaccine lipid would enter the blood stream and reach breast tissue. If it does, it is even less likely that either the intact nanoparticle or mRNA transfer into milk. In the unlikely event that mRNA is present in milk, it would be expected to be digested by the child and would be unlikely to have any biological effects.


While there is little plausible risk for the child, there is a biologically plausible benefit. Antibodies and T-cells stimulated by the vaccine may passively transfer into milk. Following vaccination against other viruses, IgA antibodies are detectable in milk within 5 to 7 days. Antibodies transferred into milk may therefore protect the infant from infection with SARS-CoV-2.


Although the biology is reassuring, for definitive information, we will have to wait for data on outcomes once the vaccine is used in lactating individuals and their children.


According to the CDC Advisory Committee on Immunization Practices, with the exception of small pox and yellow fever, vaccines during lactation do not affect the safety of breastfeeding for the mother or her child.


The ABM urges vaccine manufacturers to include data for lactating individuals and their children in periodic safety reports. Furthermore, we strongly recommend that future research studies routinely include pregnant and lactating participants. We must protect pregnant and breastfeeding people through research, not from research.

Is Online Breastfeeding A New Thing? How The Pandemic Is Changing Everything And Nothing – By Corinne Botz And Mathilde Cohen



I was recently preparing to sign on to an online faculty meeting, when my two-year old began to scream, “Tétée! Tétée!”—the French for “boob” and “suckling”—thirty seconds before start time.


With little time to think, I hit “Join Meeting,” put him on the breast, and attempted a smile. But wait—should I turn the camera off? As a legal scholar who writes about lactation as an under-recognized and unrewarded form of gendered labor, I could not possibly turn it off. I noticed that there were 50 participants on the call. Would I come across as unprofessional? Or just French? Keep the camera on, I told myself.


It was a bit scary. Uncomfortable. But I’m tenured. I’m a white, cishet woman who is privileged in many ways—the type of person who ought to use her position to make lactating labor more visible.


A couple of minutes in, a senior colleague texted me, “Are you nursing?” I wrote back, trying to project confidence, “Of course! Online public nursing, my current research topic.”


If the 2000s were the decade of the “brelfie,” that is, of carefully curated breastfeeding selfies posted on social media, 2020 could be dubbed the year of “laczoom” to connote the different ways in which people expose their lactation online. Unlike brelfies, which risk censorship on Facebook or Instagram if they violate indecency and nudity policies, laczoom happens in real time, reducing the chance that it will be blocked.


Nevertheless, much like breastfeeding out in the world is expected to be low profile—a few state laws actually require discretion—nursing online is tolerated when not too conspicuous. A woman who kept her mic and camera on while breastfeeding during a work meeting was recently shamed on Reddit by a coworker.


The pandemic and its accompanying turn to online spaces for work, socializing, education, health xcare and more, exposes the contested nature of breastfeeding as an activity many view as private when it is a matter of public importance implicating the renewal and well-being of our polity, species, other species and the environment. At the same time, the crisis challenges the public-private divide itself by transforming the home into a semi-public space through video-enabled devices.


Lactation has become simultaneously more and less visible. In the age of social distancing, nursing in public is waning from our collective sight. At the same time, a novel form of public lactation is developing online, in particular on videoconferencing platforms, which function in many ways as the new public space.


Visual artist Corinne Botz and I teamed up in April to explore this question with the goal of making parents’ infant feeding labor and experiences more knowable and visible. We connected with over thirty parents and lactation professionals.


Botz, who previously photographed lactation rooms in the workplace, was now holding virtual photo shoots using her camera and laptop to photograph in homes across the country. Botz moved with participants around their houses, guiding them on where and how to set up their device for the photographs, listening to good-night stories, meeting family members, witnessing breakfast leftovers and toys strewn on the floors. This is photography in the time of social distancing.


The pandemic makes it harder for many new parents, especially the most vulnerable and marginalized, to initiate and maintain their lactation. They are isolated, have diminished access to in-person lactation counseling and may suffer from economic hardship and illness. They may also work stressful shifts as essential workers.


Lactation can be particularly fraught for Black and Indigenous women, whose reproductive and lactating labor has historically been exploited for white interests. The COVID-19 outbreak has amplified racial disparities in maternal health and breastfeeding rates. During the first months of the pandemic, hospital restrictions on birth and breastfeeding, such as the separation of COVID-positive or COVID-suspected parents from their newborns, disproportionately affected Black and Indigenous women, reviving the history and trauma of separating enslaved and native children from their mothers.


At the same time, the coronavirus has worked as a breastfeeding campaign of sorts. Camie Goldhammer, a Sisseton-Wahpeton lactation consultant and founder of the Indigenous Breastfeeding Counselor training, reports, “lots of people … really wish that they were breastfeeding” for the immunological benefits it could confer. For some parents, the pandemic has been a catalyst for producing more milk. Alarmed by reports of infant formula shortages, Black breastfeeding specialist Nichelle Clark went as far as relactating to provide her son with milk and donate the surplus through her social circle and the Facebook group she co-founded, Breastmilk Donation for Black Mothers.


Other women ended up with a stash of frozen milk, which they did not need because they were not leaving their houses. Britta Fithian-Zurn, a white graphic designer from Oregon recounts, “I had built up this supply thinking I would go back to the office, and it was taking over our freezer. The first donation was 200 ounces or something.”


Around the nation, human milk banks have been flooded with donations. Desiree Joy Frias, a queer Afro-Latina woman and community activist, had to quit breastfeeding. But she received thousands of free ounces of donor milk from families she found online. “It’s nuts. I feel like a cat burglar packing up three coolers with all that breast milk.”


Back in 2015, anthropologist Penny van Esterik asked, “What would happen if human milk were really treated like liquid gold? What accommodations would be made for it and for its producers?”


Five years later, even during a pandemic, parents who produce this valuable resource too often continue to be unseen and unrewarded. Veronica White is a Black critical care nurse in Michigan and mother of two. “Because of the pandemic and everything, we’re really short-staffed,” she notes, “so there is no way I could get away four times during my shift to pump.”


To maintain her lactation, she purchased a $500 high-tech wearable pump allowing her to express milk during her shifts unbeknownst to most of her patients and colleagues. She saves lives but must lactate furtively.


It remains to be seen whether the emergence of videoconferencing apps as our new pandemic public space will contribute to normalizing nursing in public or further consign it to the private sphere. There are similarities here with the increased availability of lactation rooms and pods in the workplace and in public or semi-public spaces. This development has been applauded as providing a welcome alternative to nursing or pumping in bathroom stalls. But what is the message sent by these facilities (or the possibility to turn off cameras and mics)? Is it, “We support you and your infant feeding choice” or, “This activity should be concealed”?


One lesson of the COVID-19 crisis for policy and lawmakers may be that to adequately support lactation, they should take cues from the families who had positive experiences in conditions of quarantine. These are typically the well-resourced parents not working outside the home or telecommuting and who have help from their partner and others around them. They have the opportunity to engage in practices known to support lactation such as increased time at home, rest and access to breastfeeding support. In some ways, they observe traditional postpartum customs and rituals known in some cultures as confinement—which incidentally is a term also used to denote quarantine.


For all new parents to experience their preferred version of postpartum confinement, here are some of the legal and policy tools which should be available: family-centered pre- and postpartum care, universal basic income, paid parental leave, paid lactation leaves and breaks, a flexible work environment, affordable housing, universal health care and equal access to high-quality, non-discriminatory and culturally appropriate care (including lactation counseling), and sliding fee child care programs.


The Integrity of the Remote Certified Lactation Counselor® (CLC®) Examination

The Certified Lactation Counselor® (CLC®) certification identifies a professional in lactation counseling who has demonstrated the necessary skills, knowledge, and attitudes to provide clinical breastfeeding counseling and management support to families who are thinking about breastfeeding or who have questions or problems during the course of breastfeeding/lactation. The integrity of the credential and what it represents in the lactation support provider landscape is important to families seeking professional lactation care and to the Academy of Lactation Policy and Practice (ALPP). CLCs are dedicated to the promotion, protection, and support of breastfeeding and human lactation in their work to prevent and solve breastfeeding problems. They understand that breastfeeding works best when it is the cultural norm and when the provider of lactation support and services is culturally competent.


The CLC® certification program is accredited by the prestigious American National Standards Institute (ANSI) and upholds the best practices that come along with such accreditation. ANSI accreditation represents a significant accomplishment and signifies a commitment to excellence. Our ANSI accreditation means that the CLC® certification program undergoes a rigorous review every year focusing on key components of the program including, sound governance and financial practices, management by professional certification staff, involvement by subject matter experts (SMEs), annual psychometric review of the certification examination, and a secure examination administration.

These accreditation standards are also of increasing importance when utilizing Live Remote Proctoring for the CLC® examination. ALPP began remote proctoring of the CLC® examination in May of 2020 in response to the COVID-19 pandemic. ALPP is proud to announce that this new mode of CLC® examination administration has been added to the ANSI-accredited CLC® certification program, meaning that all ANSI certification standards now apply to remotely proctored CLC® examinations as well as those examinations administered in-person when it is safe to resume to do so.


ALPP will continue to ensure that all CLC examinations are confidential, secure, valid, fair, and reliable across all modes of administration so that each newly certified CLC® and all of the families they support feel confident in their abilities, knowledge, and skills as a professional lactation care provider.

New Lactation Counselors on BCHC Team



Boone County Health Center has announced the addition of two Certified Lactation Counselors (CLCs) to the obstetrics (OB) team.

Alyssa Henn, RN, and Kendra Vogel, RN, will join Deanna Kruse, RN, and Maria Kinney, RN, as CLCs.

“Breastfeeding is natural, but it is also a learned skill. As CLCs we have special training from a practical, evidence-based breastfeeding course with a strong focus on counseling skills to help moms and babies have the best breastfeeding experience possible,” said Obstetrics Director Maria Kinney, RN.

At Boone County Health Center, CLCs offer patients a free breastfeeding class to review the benefits of breastfeeding, positioning of the baby, and how to determine if the baby is getting enough milk. During the hospital stay, CLCs are available to help mothers and babies begin their breastfeeding journey.

Doctor On Call: Questions For Dr. Asbury, A Breastfeeding Pediatrician



How does your dual role as a pediatrician and lactation counselor help moms with breastfeeding?
One of the biggest stresses for new moms is breastfeeding. Even though it’s completely natural, it’s not always easy. I’ve seen many tearful moms in my office who were experiencing a painful latch, concerned about their milk supply or worried about a host of other breastfeeding problems. As a pediatrician who is certified in lactation counseling, I can provide some much-needed support for these moms, and it’s a great way to help my little patients get off to a healthy start.


What are some advantages for babies who breastfeed? 
The advantages of breastfeeding for babies go far beyond filling up a hungry belly. Breast milk is the best food for babies during the first year of life (with the addition of baby foods after six months). In addition to the perfect balance of nutrients to help a baby grow, breast milk helps reduce illnesses like ear infections, pneumonia and diarrhea, as well as lowering the impact of respiratory illnesses.


Breastfeeding helps decrease the incidence of asthma and eczema. The rates of obesity and type 1 diabetes are much lower in breastfed infants as compared to formula fed infants, and breastfeeding is associated with a reduced risk of sudden infant death syndrome (SIDS) and childhood leukemia.  


How can mothers benefit from breastfeeding? 

There are several maternal benefits of breastfeeding, and lactation plays an important role in a woman’s long-term health. Breastfeeding can help lower the lifetime risks of metabolic disease often associated with insulin resistance and high cholesterol brought on during pregnancy.


It can also reduce maternal obesity, lower the risk of diabetes, high blood pressure, and heart disease (including heart attacks). Breastfeeding has been shown to reduce the risk of type 2 diabetes after developing gestational diabetes during pregnancy. 


Breastfeeding also reduces a mother’s risk for endometrial, ovarian and breast cancers. Long-term studies have shown that the longer a woman breastfeeds the more she can reduce her breast cancer risk, particularly the most aggressive forms of the disease such as triple negative breast cancer.


What kind of support do you give breastfeeding moms?

I encourage my patients often, because they need to hear the effort they’re making for their own health and the long-term health of their baby is the first step for them to be successful in this endeavor. 


I tell my patients that breastfeeding is a labor of love because it’s not always an easy, painless journey. Infants often need to be fed every 1-3 hours for the first few weeks of life. This can create mental and physical exhaustion for the mom on top of the fluctuating hormones that occur after delivery. 


As a pediatrician and a lactation counselor, I can offer successful strategies for breastfeeding, address factors that have a negative impact on the mother-baby bond, and support them through difficult seasons which make lifelong impacts for both mom and baby.  


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Laura Asbury MD CLC is a pediatrician with Beacon’s Children’s Diagnostic Center who has more than 15 years experience caring for children, and has recently become a certified lactation counselor to give new moms and babies added support in their breastfeeding journey.  She earned her medical degree from the University of Tennessee School of Medicine in Memphis and completed her residency and chief residency at T.C. Thompson Children’s Hospital in Chattanooga.   


Dr. Laura Asbury is accepting new patients.  Call and make an appointment with her at 894-3252.